發(fā)布時(shí)間：2018-11-13 18:05

【摘要】：目的:本實(shí)驗(yàn)旨在通過(guò)建立SD大鼠急性心肌缺血模型,來(lái)對(duì)比低氧預(yù)適應(yīng)與遠(yuǎn)隔缺血預(yù)處理兩種方式在急性心肌缺血情況下的心肌保護(hù)作用。方法:選取60只SD雄性大鼠,體重284g±56g(220g~350g),隨機(jī)分為4組,分別為1.空白對(duì)照組2.模型組3.低氧預(yù)適應(yīng)組(HP組)4.遠(yuǎn)隔缺血預(yù)處理組(RIP組)。每組都給予普通飼料喂養(yǎng)。其中第3組先予以15d低氧預(yù)適應(yīng)處理,第4組建模前24h予以普通橡膠帶結(jié)扎大鼠尾部,形成遠(yuǎn)隔肢端缺血預(yù)處理。第2組、3組、4組大鼠予以尾靜脈注射2u/kg垂體后葉素,并分別于注射后30min內(nèi)觀測(cè)心電監(jiān)護(hù)儀II導(dǎo)聯(lián)心電圖。實(shí)驗(yàn)建模成功后24h胸腔采血測(cè)定心肌肌鈣蛋白T(Cardiac troponin T,cTnT)、肌型肌酸激酶同工酶(Creatine kinase-MB,CK-MB)、超氧化物歧化酶(Superoxidide Dismutase,SOD)和丙二醛(Malondialdehyde,MDA)、促紅細(xì)胞生成素(Erythropoietin,EPO)。取心尖部肌肉組織,甲醛固定后,石蠟包埋,制作切片,HE染色后觀察其病理學(xué)改變。結(jié)果:(1)低氧預(yù)適應(yīng)與遠(yuǎn)隔缺血預(yù)處理都具有良好的心肌保護(hù)作用;與模型組相比HP組與RIP組大鼠,心衰癥狀顯著減輕,注射垂體后葉素后心電圖顯示J點(diǎn)抬高不明顯,CK-MB、cTnT、MDA降低,SOD上升。HP與RIP組EPO均低于模型組,心律失常評(píng)分也低于模型組。心肌病理切片超微結(jié)果顯示:較對(duì)照組心梗面積減少,心肌細(xì)胞水腫變性減輕,結(jié)構(gòu)更清晰。(2)HP組與RIP組相比心律失常評(píng)分無(wú)顯著差異(P0.05),CK-MB、cTnT、SOD、MDA較RIP組水平高,EPO顯著高于RIP組。心衰癥狀統(tǒng)計(jì)無(wú)明顯統(tǒng)計(jì)學(xué)差異。病理結(jié)構(gòu)顯示心肌細(xì)胞損傷較RIP稍嚴(yán)重,梗死范圍較大,心肌組織中可見(jiàn)新生毛細(xì)血管生成。結(jié)論:(1)低氧預(yù)處理與遠(yuǎn)隔缺血預(yù)適應(yīng)都能為急性心肌缺血提供顯著的心肌保護(hù)作用(2)低氧預(yù)適應(yīng)在降低心肌損傷標(biāo)志物的水平上與心肌組織超微結(jié)構(gòu)保護(hù)上弱于遠(yuǎn)隔缺血預(yù)適應(yīng)的第二保護(hù)窗口期。(3)RIP組與HP組均與空白對(duì)照組在CK-MB、cTnT上有顯著差異(P0.01)。
[Abstract]:Aim: to compare the protective effects of hypoxic preconditioning and distant ischemic preconditioning on acute myocardial ischemia in SD rats. Methods: 60 male SD rats, weighing 284g 鹵56g (220g~350g), were randomly divided into 4 groups, 1. Blank control group 2. Model group 3. Hypoxia preconditioning group (HP group) 4. Distant ischemic preconditioning group (RIP group). Each group was fed with general feed. The third group was treated with hypoxic preconditioning for 15 days, the fourth group was treated with common rubber band ligation of the rat tail 24 hours before modeling, and the distal limb ischemic preconditioning was formed. Group 2, group 3 and group 4 were injected with 2u/kg pituitrin via caudal vein, and electrocardiogram (ECG) of II lead of ECG monitor were observed in 30min after injection. Cardiac troponin (T (Cardiac troponin), creatine kinase isoenzyme (Creatine kinase-MB,CK-MB), superoxide dismutase (Superoxidide Dismutase,SOD) and malondialdehyde (Malondialdehyde,MDA) were measured 24 hours after modeling. Erythropoietin (Erythropoietin,EPO). The muscle tissue of the apical region was taken and fixed with formaldehyde, then embedded in paraffin and made into sections. The pathological changes were observed after HE staining. Results: (1) both hypoxic preconditioning and distant ischemic preconditioning had good myocardial protection. Compared with the model group, the symptoms of heart failure in HP group and RIP group were significantly alleviated. The ECG showed that J point elevation was not obvious, CK-MB,cTnT,MDA was decreased, SOD was increased, EPO in HP and RIP group was lower than that in model group. The arrhythmia score was also lower than that in the model group. The ultrastructural results of myocardial pathological sections showed that compared with the control group, myocardial infarction area decreased, myocardial cell edema and degeneration decreased, and the structure was clearer. (2) there was no significant difference in arrhythmia score between HP group and RIP group (P0.05), CK-MB,cTnT,SOD,. The level of MDA was higher than that of RIP, and EPO was significantly higher than that of RIP. There was no statistical difference in symptoms of heart failure. The pathological structure showed that myocardial cell injury was a little more serious than RIP, the infarct area was larger, and neovascularization could be seen in myocardial tissue. Conclusion: (1) hypoxia preconditioning and distant ischemic preconditioning can provide significant myocardial protection for acute myocardial ischemia. (2) hypoxia preconditioning can reduce myocardial injury markers and myocardial ultrastructure. (3) both RIP group and HP group were in CK-MB,. There was significant difference in cTnT (P0.01).
【學(xué)位授予單位】：川北醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R654.1

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